Recognizing anxiety disorders
Normal anxiety is a protective response to genuine threats. An anxiety disorder occurs when anxiety is excessive, persistent (lasting weeks to months), disproportionate to the actual situation, and significantly interferes with daily functioning. The most common types are: Generalized Anxiety Disorder (GAD) — chronic, difficult-to-control worry about multiple areas of life; Panic Disorder — recurrent unexpected panic attacks; Social Anxiety Disorder — intense fear of social situations and judgment; and specific phobias.
Anxiety has both psychological and physical symptoms. Psychological: excessive worry, difficulty concentrating, irritability, fear of losing control. Physical: palpitations, sweating, trembling, shortness of breath, chest tightness, nausea, dizziness, muscle tension, and insomnia. Many people with anxiety disorders first seek medical help for the physical symptoms — thinking they have a heart problem — without realizing the cause is psychological.
Key facts
- ✓Anxiety disorders are highly treatable: 60–80% of people respond well to therapy, medication, or both
- ✓Cognitive-behavioral therapy (CBT) has the strongest evidence base and produces lasting results
- ✓SSRIs (sertraline, escitalopram) are first-line medication — they take 4–6 weeks to work
- ✓Benzodiazepines work fast but are not first-line due to dependence risk with prolonged use
- ✓Regular aerobic exercise reduces anxiety symptoms with an effect size comparable to medication in mild cases
Talk to a doctor about anxiety
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Psychotherapy: CBT is the gold standard for anxiety disorders. It identifies and changes anxiety-maintaining thought patterns and behaviors, and includes exposure techniques. Typically 8–20 sessions, with effects that outlast medication after treatment ends. Medication: SSRIs such as sertraline (50–200 mg/day) and escitalopram (10–20 mg/day) are first-line. They require 4–6 weeks for full effect and should be maintained for at least 12 months after symptom remission. SNRIs (venlafaxine, duloxetine) are an alternative. Buspirone is a non-addictive option effective for GAD.
Benzodiazepines (alprazolam, lorazepam, clonazepam) provide rapid relief but should be used short-term only due to tolerance and dependence risk. Beta-blockers (propranolol) can reduce physical symptoms of anxiety (palpitations, tremor) in situational anxiety like public speaking, but don't address the underlying disorder. A doctor must evaluate the full picture before prescribing any medication for anxiety.
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Regular aerobic exercise (150 min/week) reduces cortisol and stimulates GABA and endorphins — one of the most effective non-pharmacological anxiety interventions. Consistent sleep schedule (7–9 hours, same time daily) is essential: sleep deprivation markedly worsens anxiety. Limiting caffeine (a direct anxiogenic) and alcohol (disrupts sleep architecture and worsens rebound anxiety) makes a significant difference. Diaphragmatic breathing — inhale 4 seconds, hold 2, exhale 6 — activates the parasympathetic nervous system and interrupts the panic cycle.
Avoid avoidance behaviors: skipping feared situations temporarily relieves anxiety but strengthens the disorder long-term. Gradually confronting feared situations is essential for lasting improvement. Mindfulness practice (10–20 min daily) and structured daily routines reduce the uncertainty that feeds anxious thinking. Strong social connections are also protective — isolation consistently worsens anxiety outcomes.
FAQ
Can a general physician treat anxiety?
Yes. A general physician can diagnose anxiety disorders, rule out physical causes (hyperthyroidism, cardiac arrhythmia), prescribe SSRIs, and refer to psychology or psychiatry as needed. This is often the most accessible first step.
How do SSRIs work for anxiety?
SSRIs normalize anxiety signaling by increasing serotonin availability in the brain. They are not sedatives or "happy pills" — they reduce the intensity of the anxiety response over several weeks. Full effects take 4–6 weeks, and some initial worsening in the first 1–2 weeks is common and expected.
Are anxiety medications addictive?
SSRIs are not addictive. Benzodiazepines can create physical dependence with prolonged use, which is why they are recommended only short-term. Always follow your doctor's guidance when stopping any anxiety medication to avoid discontinuation effects.
Can anxiety be cured?
Many people achieve full remission with treatment. CBT provides tools that last a lifetime. Even when anxiety doesn't disappear entirely, treatment significantly reduces its impact on daily functioning, and most people manage it very effectively long-term.
Conclusion
Anxiety disorders are common, diagnosable, and very treatable. Whether you need therapy, medication, or both, the first step is a medical consultation to understand what's happening and create a treatment plan tailored to your situation.
At Delvir, you can consult a physician online from S/80, from anywhere in Peru.